Sleep apnea physical examination

Sleep Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Sleep apnea from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Polysomnography
Home Oximetry
CT
MRI
Ultrasound
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Sleep apnea physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Sleep apnea physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Sleep apnea physical examination
CDC on Sleep apnea physical examination
Sleep apnea physical examination in the news
Blogs on Sleep apnea physical examination
Directions to Hospitals Treating Sleep apnea
Risk calculators and risk factors for Sleep apnea physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

Overview

Generally, the most common signs of sleep apnea are a large waist/neck circumference and facial deformities. If sleep apnea is left untreated, signs of for pulmonale, stroke, hypoxemia, and pulmonary hypertension are evident.

Sleep Apnea Physical Examination

General appearance

• Obese

• Lethargy
• Confusion
• Irritable
• Sitting up and leaning forward to improve diaphragmatic breathing
• Children may not grow at a normal rate

Vital Signs

Vital signs are generally within normal limit, but patients with severe disease may have the following vital signs:

• Decreased SPO2
• Tachyapnea
• Tachycardia
• High BP

Chest

• Wheeze
• Pleural effusion

Heart

• Right ventricular hypertrophy (RVH)
• Left parasternal systolic lift
• 3rd/4th heart sounds and pansystolic murmur of tricuspid regurgitation over right heart
• Split second heart sound with loud pulmonary component
• Systolic ejection murmur with a sharp ejection click over the pulmonary artery
• Diastolic pulmonary regurgitation murmur over the pulmonary artery

Abdomen

• Ascites
• Hepatomegaly
• Large waist circumference

Skin

• Cyanosis

ENT

• Large neck circumference

• Particularly prominent among men who have a collar size greater than 17 inches and women who have a collar size greater than 16 inches

• Retrognathia
• Micrognathia
• Lateral peritonsillar narrowing
• Macroglossia
• Tonsillar hypertrophy
• Elongated or enlarged uvula
• A high arched or narrow palate
• Nasal septal deviation
• Nasal polyps
• Increased jugular venous pressure
• Prominent neck and facial veins

Extremeties

• Digital clubbing
• Pedal edema